Metabolic Syndrome Associated with Tobacco and Caffeine Products Use Among Refugee Adolescents: Risk of Dyslipidemia

Abstract

Introduction Due to their stressful lives, Palestinian refugees are prone to use cognitive enhancers (CE) and psychostimulant substances (PS). Recognising health problems associated with CE/PS use can indicate how preventive programs should be directed towards adolescents. Unfortunately, research has not thoroughly investigated the health problems related to tobacco and caffeine products, the most socially acceptable CE/PS among Palestinian refugee adolescents. Methodology In 2021, schoolchildren from five Palestinian refugee camps (N=271) aged 12-<16 years agreed to give blood samples and to be interviewed to address the association between metabolic syndrome (MetS) and tobacco smoking, coffee, energy drinks (ED), black tea, and chocolate consumption. MetS was diagnosed based on International Diabetic Federation Criteria. To address the association, we used binary logistic regression models adjusted to age, gender, BMI, and central obesity. Results The prevalence of MetS was [17 (6.3%)]; (7.4%) in males, (5.1%) in females. The prevalence of substance use was as follows: ED [163 (48.9%)], coffee [255 (76.6%)], black tea [295 (89.1%)], cigarette [35 (10.5%)], waterpipe [59 (17.7%)], and chocolate [309 (93.6%)], with male predominance. Cigarette smokers have increased central obesity (p-value=0.024), and decreased HDL-cholesterol (p-value=0.015) than non-smokers. Similar results were observed for waterpipe smokers besides the increased levels of triglycerides (p-value=0.01). ED consumers have increased central obesity (p-value=0.03) and fast blood sugar (p-value=0.003) than non-consumers. Chocolate consumers have decreased central obesity (p-value=0.008) and increased HDL levels (p-value=0.04) than non-consumers. ED consumers were significantly at higher risk of MetS (OR=9.97, p-value=0.019) than non-consumers and chocolate consumers were at lower risk of MetS (OR=0.14, p-value=0.046) than non-consumers. Waterpipe smokers were at a higher risk of having increased plasma triglycerides than non-consumers (OR=3.4, p-value=0.03). Conclusion The high prevalence of ED consumption and waterpipe smoking in Palestinian refugee adolescents is problematic. Their use was associated with higher odds of MetS, dyslipidemia, and central obesity, which justifies greater attention.

Risk of Tobacco Smoking and Consumption of Energy Drinks on Obesity and Central Obesity Among Male University Students

“…In a previous study, ED consumption was associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors [ 21 ]. In contrast to a local study among adolescent refugees [ 34 ], ED consumption was not associated with increased central obesity. This discrepancy in results between adolescents and young adults can be related to the adolescence period or the amount of ED consumption, which was not tested in this study.…”

“…Due to the overlapping toxicant and chemical profile to conventional cigarettes, the effects of waterpipe smoke on the cardiovascular system are thought to be comparable to those of conventional cigarettes [ 58 ]. Although an inverse relationship between cigarette smoking and overall obesity was observed, consistent with other local and global studies, waterpipe smoking was linked to a higher risk of increased central obesity in this study [ 34 , 59 ]. Furthermore, waterpipe smoking was linked to an increased risk of central obesity and dyslipidemia among young Palestinian adults and adolescents, as reported by a few Palestinian studies [ 34 ].…”

“…Although an inverse relationship between cigarette smoking and overall obesity was observed, consistent with other local and global studies, waterpipe smoking was linked to a higher risk of increased central obesity in this study [ 34 , 59 ]. Furthermore, waterpipe smoking was linked to an increased risk of central obesity and dyslipidemia among young Palestinian adults and adolescents, as reported by a few Palestinian studies [ 34 ]. These disorders increase the risk of developing metabolic syndrome and thrombosis [ 11 ].…”

“…A previous study reported that coffee and chocolate consumption was associated with decreased risk of eating disorders only among males [ 34 ]. Obsessive chocolate eaters scored higher on drive measures for thinness, body dissatisfaction, bulimia, and binge eating disorders [ 49 , 50 ].…”

“…The prevalence of being overweight and obese in young adulthood is increasing exponentially globally, including Palestine [4,[30][31][32][33][34]. Recognizing obesity-related risk factors can help reduce the risk of obesityrelated disorders.…”